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Mbanzulu KM, Mboera LEG, Wumba R, Zanga JK, Luzolo FK, Misinzo G, Kimera SI. Community Knowledge, Attitude, and Practices Regarding Mosquitoes and Mosquito-Borne Viral Diseases in Kinshasa, Democratic Republic of the Congo. EPIDEMIOLOGIA (BASEL, SWITZERLAND) 2022; 4:1-17. [PMID: 36648775 PMCID: PMC9844489 DOI: 10.3390/epidemiologia4010001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/22/2022] [Accepted: 08/29/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND OBJECTIVES Mosquito-borne viral diseases (MBVDs) create a dramatic health situation worldwide. There is a need to improve the understanding of factors to be addressed in intervention programmes. This study explored community knowledge, attitudes, and practices (KAP) regarding MBVD in Kinshasa. MATERIALS AND METHODS A cross-sectional survey was carried out between January and April 2019. The socio-demographic and KAP data collected through a questionnaire were analysed using Epi Info 7. RESULTS The study included 1464 male and female respondents aged from 18 to 70 years old. Open garbage cans and outdoor water storage units were found in 61.2% and 33.4% of respondent residences, respectively. Polluted water bodies (80.3%) were the most mentioned as mosquito breeding places. Among 86.6% of the respondents that had heard about yellow fever, 12% knew that it is an MBVD. The majority of respondents (72.5%) were perceived to be at risk of contracting MBVD. Environment sanitation (58%) and insecticide use (25%) were among the measures implemented to control mosquitoes. The greater overall knowledge score and attitude were not associated with good practice. CONCLUSION The residents of Kinshasa had limited knowledge of MBVD. Raising awareness and educational sessions are essential in empowering the community regarding the correct attitudes and practices to effectively manage the risk posed by MBVD.
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Affiliation(s)
- Kennedy M. Mbanzulu
- SACIDS Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, Chuo Kikuu, Morogoro P.O. Box 3297, Tanzania
- Department of Tropical Medicine, Infectious and Parasitic Diseases, University of Kinshasa, Kinshasa P.O. Box 747, Democratic Republic of the Congo
- Department of Veterinary Microbiology, Parasitology and Biotechnology, Sokoine University of Agriculture, Chuo Kikuu, Morogoro P.O. Box 3019, Tanzania
- Correspondence: ; Tel.: +243-898788072
| | - Leonard E. G. Mboera
- SACIDS Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, Chuo Kikuu, Morogoro P.O. Box 3297, Tanzania
| | - Roger Wumba
- Department of Tropical Medicine, Infectious and Parasitic Diseases, University of Kinshasa, Kinshasa P.O. Box 747, Democratic Republic of the Congo
| | - Josué K. Zanga
- Department of Tropical Medicine, Infectious and Parasitic Diseases, University of Kinshasa, Kinshasa P.O. Box 747, Democratic Republic of the Congo
| | - Flory K. Luzolo
- Department of Tropical Medicine, Infectious and Parasitic Diseases, University of Kinshasa, Kinshasa P.O. Box 747, Democratic Republic of the Congo
| | - Gerald Misinzo
- SACIDS Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, Chuo Kikuu, Morogoro P.O. Box 3297, Tanzania
- Department of Veterinary Microbiology, Parasitology and Biotechnology, Sokoine University of Agriculture, Chuo Kikuu, Morogoro P.O. Box 3019, Tanzania
| | - Sharadhuli I. Kimera
- SACIDS Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, Chuo Kikuu, Morogoro P.O. Box 3297, Tanzania
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Chuo Kikuu, Morogoro P.O. Box 3021, Tanzania
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García-Carrasco JM, Muñoz AR, Olivero J, Segura M, Real R. An African West Nile virus risk map for travellers and clinicians. Travel Med Infect Dis 2022; 52:102529. [PMID: 36549415 DOI: 10.1016/j.tmaid.2022.102529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/21/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022]
Abstract
International travellers are exposed to pathogens not commonly found in their countries of residence, including West Nile virus (WNV). Due to the difficulty of its diagnosis, little is known about its distribution in Africa. Understanding the geographic extent of risk of WNV infections is a necessity for both travellers and clinicians who advise and treat them, since there is no human vaccine. To date, there is no risk map for WNV infections in humans in Africa. Having a high-resolution risk map for the virus could be of relevance before the trip, to take preventive measures, and after the trip, for appropriate diagnosis of the disease. Virus detection in humans along the African continent were collected from official reports, and published scientific research for the period 1940 to 2020, and then geo-referenced in order to use biogeographical modelling for WNV. Models were based on fuzzy logic and machine learning algorithms and were designed to identify the environmental drivers that explain the distribution of human cases and to locate favourable areas for infections. We elaborated a high-resolution risk map for WNV infections that highlights favourable areas for infections in Africa. Although WNV infections are widely spread across Africa, the risk of the disease is not homogenously distributed. Popular tourist destinations such as Morocco, Tunisia, and South Africa, are high-risk areas for WNV infection.
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Affiliation(s)
- José-María García-Carrasco
- Biogeography, Diversity and Conservation Lab, Department of Animal Biology, Faculty of Sciences, University of Málaga, 29071, Málaga, Spain.
| | - Antonio-Román Muñoz
- Biogeography, Diversity and Conservation Lab, Department of Animal Biology, Faculty of Sciences, University of Málaga, 29071, Málaga, Spain.
| | - Jesús Olivero
- Biogeography, Diversity and Conservation Lab, Department of Animal Biology, Faculty of Sciences, University of Málaga, 29071, Málaga, Spain.
| | - Marina Segura
- International Vaccination Center of Malaga, Maritime Port of Malaga, Ministry of Health, Consumption and Social Welfare, Government of Spain, Malaga, Spain.
| | - Raimundo Real
- Biogeography, Diversity and Conservation Lab, Department of Animal Biology, Faculty of Sciences, University of Málaga, 29071, Málaga, Spain.
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Abstract
Purpose of Review West Nile virus (WNV) is an arbovirus transmitted by mosquitos of the genus Culex. Manifestations of WNV infection range from asymptomatic to devastating neuroinvasive disease leading to flaccid paralysis and death. This review examines WNV epidemiology and ecology, with an emphasis on travel-associated infection. Recent Findings WNV is widespread, including North America and Europe, where its range has expanded in the past decade. Rising temperatures in temperate regions are predicted to lead to an increased abundance of Culex mosquitoes and an increase in their ability to transmit WNV. Although the epidemiologic patterns of WNV appear variable, its geographic distribution most certainly will continue to increase. Travelers are at risk for WNV infection and its complications. Literature review identified 39 cases of documented travel-related WNV disease, the majority of which resulted in adverse outcomes, such as neuroinvasive disease, prolonged recovery period, or death. Summary The prediction of WNV risk is challenging due to the complex interactions of vector, pathogen, host, and environment. Travelers planning to visit endemic areas should be advised regarding WNV risk and mosquito bite prevention. Evaluation of ill travelers with compatible symptoms should consider the diagnosis of WNV for those visiting in endemic areas as well as for those returning from destinations with known WNV circulation.
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From a long-distance threat to the invasion front: a review of the invasive Aedes mosquito species in Belgium between 2007 and 2020. Parasit Vectors 2022; 15:206. [PMID: 35698108 PMCID: PMC9195248 DOI: 10.1186/s13071-022-05303-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 04/26/2022] [Indexed: 11/10/2022] Open
Abstract
Invasive mosquito species (IMS) and their associated mosquito-borne diseases are emerging in Europe. In Belgium, the first detection of Aedes albopictus (Skuse 1894) occurred in 2000 and of Aedes japonicus japonicus (Theobald 1901) in 2002. Early detection and control of these IMS at points of entry (PoEs) are of paramount importance to slow down any possible establishment. This article reviews the introductions and establishments recorded of three IMS in Belgium based on published (2007–2014) and unpublished (2015–2020) data collected during several surveillance projects. In total, 52 PoEs were monitored at least once for the presence of IMS between 2007 and 2020. These included used tyre and lucky bamboo import companies, airports, ports, parking lots along highways, shelters for imported cutting plants, wholesale markets, industrial areas, recycling areas, cemeteries and an allotment garden at the country border with colonised areas. In general, monitoring was performed between April and November. Mosquitoes were captured with adult and oviposition traps as well as by larval sampling. Aedes albopictus was detected at ten PoEs, Ae. japonicus at three PoEs and Aedes koreicus (Edwards 1917) at two PoEs. The latter two species have established overwintering populations. The percentage of PoEs positive for Ae. albopictus increased significantly over years. Aedes albopictus is currently entering Belgium through lucky bamboo and used tyre trade and passive ground transport, while Ae. japonicus through used tyre trade and probably passive ground transport. In Belgium, the import through passive ground transport was first recorded in 2018 and its importance seems to be growing. Belgium is currently at the invasion front of Ae. albopictus and Ae. japonicus. The surveillance and control management actions at well-known PoEs associated to long-distance introductions are more straightforward than at less-defined PoEs associated with short-distance introductions from colonised areas. These latter PoEs represent a new challenge for IMS management in Belgium in the coming years. Aedes albopictus is expected to become established in Belgium in the coming years, hence increasing the likelihood of local arbovirus transmission. The implementation of a sustainable, structured and long-term IMS management programme, integrating active and passive entomological surveillance, vector control and Public Health surveillance is therefore pivotal.
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Falconi-Agapito F, Kerkhof K, Merino X, Bakokimi D, Torres F, Van Esbroeck M, Talledo M, Ariën KK. Peptide Biomarkers for the Diagnosis of Dengue Infection. Front Immunol 2022; 13:793882. [PMID: 35154111 PMCID: PMC8826428 DOI: 10.3389/fimmu.2022.793882] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
In a world with an increasing population at risk of exposure to arthropod-borne flaviviruses, access to timely and accurate diagnostic tests would impact profoundly on the management of cases. Twenty peptides previously identified using a flavivirus proteome-wide microarray were evaluated to determine their discriminatory potential to detect dengue virus (DENV) infection. This included nine peptides recognized by IgM antibodies (PM peptides) and 11 peptides recognized by IgG antibodies (PG peptides). A bead-based multiplex peptide immunoassay (MPIA) using the Luminex technology was set-up to determine Ab binding levels to each of these peptides in a panel of 323 carefully selected human serum samples. Sera are derived from individuals either infected with different viruses, namely, the four DENV serotypes, Zika virus (ZIKV), yellow fever virus (YFV), chikungunya virus (CHIKV), West Nile virus (WNV) and Human immunodeficiency virus (HIV), or receiving vaccination against YFV, tick-borne encephalitis (TBEV), and Japanese encephalitis virus (JEV). Additionally, a set of healthy controls were included. We targeted a minimum specificity of 80% for all the analysis. The PG-9 peptide had the best sensitivity (73%) when testing DENV sera from acute patients (A-DENV; <8 days since symptom onset). With sera from convalescent DENV patients (C-DENV; >10 days since symptom onset) the FPG-1 peptide was the best seromarker with a sensitivity of 86%. When combining all A-DENV and C-DENV samples, peptides PM-22 and FPG-1 had the best-diagnostic performance with a sensitivity of 60 and 61.1%, and areas under the curve (AUC) of 0.7865 and 0.8131, respectively. A Random forest (RF) algorithm was used to select the best combination of peptides to classify DENV infection at a targeted specificity >80%. The best RF model for PM peptides that included A-DENV and C-DENV samples, reached a sensitivity of 72.3%, while for PG peptides, the best RF models for A-DENV only, C-DENV only and A-DENV + C-DENV reached a sensitivity of 88.9%, 89.1%, and 88.3%, respectively. In conclusion, the combination of multiple peptides constitutes a founding set of seromarkers for the discrimination of DENV infected individuals from other flavivirus infections.
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Affiliation(s)
- Francesca Falconi-Agapito
- Department of Biomedical Sciences, Unit of Virology, Institute of Tropical Medicine, Antwerp, Belgium
- Virology Unit, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Karen Kerkhof
- Department of Biomedical Sciences, Unit of Virology, Institute of Tropical Medicine, Antwerp, Belgium
| | - Xiomara Merino
- Virology Unit, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Diana Bakokimi
- Department of Biomedical Sciences, Unit of Virology, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Marjan Van Esbroeck
- Department of Clinical Sciences, National Reference Center for Arboviruses, Institute of Tropical Medicine, Antwerp, Belgium
| | - Michael Talledo
- Virology Unit, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Kevin K. Ariën
- Department of Biomedical Sciences, Unit of Virology, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
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Mbanzulu KM, Mboera LEG, Luzolo FK, Wumba R, Misinzo G, Kimera SI. Mosquito-borne viral diseases in the Democratic Republic of the Congo: a review. Parasit Vectors 2020; 13:103. [PMID: 32103776 PMCID: PMC7045448 DOI: 10.1186/s13071-020-3985-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 02/18/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Mosquito-borne viral infections have in recent years, become a public health threat globally. This review aimed to provide an overview of the ecological and epidemiological profiles of mosquito-borne viral infections in the Democratic Republic of the Congo (DRC). METHODS A search of literature was conducted using Google Scholar, PubMed and the WHO website using the following keywords: "Democratic Republic of the Congo", "Zaire", "Belgian Congo" and either of the following: "mosquito-borne virus", "arbovirus", "yellow fever", "dengue", "chikungunya", "West Nile", "Rift Valley fever", "O'nyong'nyong", "Zika", "epidemiology", "ecology", "morbidity", "mortality". Published articles in English or French covering a period between 1912 and October 2018 were reviewed. RESULTS A total of 37 articles were included in the review. The findings indicate that the burden of mosquito-borne viral infections in DRC is increasing over time and space. The north-western, north-eastern, western and central regions have the highest burden of mosquito-borne viral infections compared to south and eastern highland regions. Yellow fever, chikungunya, dengue, Zika, Rift Valley fever, West Nile and O'nyong'nyong have been reported in the country. These mosquito-borne viruses were found circulating in human, wildlife and domestic animals. Yellow fever and chikungunya outbreaks have been frequently reported. Aedes aegypti and Ae. simpsoni were documented as the main vectors of most of the mosquito-borne viral infections. Heavy rains, human movements, forest encroachment and deforestation were identified as drivers of mosquito-borne viruses occurrence in DRC. CONCLUSIONS Mosquito-borne viral infections are becoming common and a serious public health problem in DRC. In the current context of climate change, there is urgent need to improve understanding on ecological and epidemiology of the diseases and strengthen surveillance systems for prompt response to epidemics in DRC.
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Affiliation(s)
- Kennedy M. Mbanzulu
- SACIDS-Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, P.O. Box 3297, Chuo Kikuu, Morogoro, Tanzania
- Department of Tropical Medicine, Infectious and Parasitic Diseases, University of Kinshasa, P.O. Box 747, Kinshasa, Democratic Republic of the Congo
- Department of Veterinary Microbiology, Parasitology and Biotechnology, Sokoine University of Agriculture, P.O. Box 3019, Chuo Kikuu, Morogoro, Tanzania
| | - Leonard E. G. Mboera
- SACIDS-Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, P.O. Box 3297, Chuo Kikuu, Morogoro, Tanzania
| | - Flory K. Luzolo
- Department of Tropical Medicine, Infectious and Parasitic Diseases, University of Kinshasa, P.O. Box 747, Kinshasa, Democratic Republic of the Congo
| | - Roger Wumba
- Department of Tropical Medicine, Infectious and Parasitic Diseases, University of Kinshasa, P.O. Box 747, Kinshasa, Democratic Republic of the Congo
| | - Gerald Misinzo
- SACIDS-Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, P.O. Box 3297, Chuo Kikuu, Morogoro, Tanzania
- Department of Veterinary Microbiology, Parasitology and Biotechnology, Sokoine University of Agriculture, P.O. Box 3019, Chuo Kikuu, Morogoro, Tanzania
| | - Sharadhuli I. Kimera
- SACIDS-Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, P.O. Box 3297, Chuo Kikuu, Morogoro, Tanzania
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Chuo Kikuu, Morogoro, Tanzania
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Martinet JP, Ferté H, Failloux AB, Schaffner F, Depaquit J. Mosquitoes of North-Western Europe as Potential Vectors of Arboviruses: A Review. Viruses 2019; 11:v11111059. [PMID: 31739553 PMCID: PMC6893686 DOI: 10.3390/v11111059] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/06/2019] [Accepted: 11/08/2019] [Indexed: 12/22/2022] Open
Abstract
Background: The intensification of trade and travel is linked to the growing number of imported cases of dengue, chikungunya or Zika viruses into continental Europe and to the expansion of invasive mosquito species such as Aedes albopictus and Aedes japonicus. Local outbreaks have already occurred in several European countries. Very little information exists on the vector competence of native mosquitoes for arboviruses. As such, the vectorial status of the nine mosquito species largely established in North-Western Europe (Aedes cinereus and Aedes geminus, Aedes cantans, Aedes punctor, Aedes rusticus, Anopheles claviger s.s., Anopheles plumbeus, Coquillettidia richiardii, Culex pipiens s.l., and Culiseta annulata) remains mostly unknown. Objectives: To review the vector competence of both invasive and native mosquito populations found in North-Western Europe (i.e., France, Belgium, Germany, United Kingdom, Ireland, The Netherlands, Luxembourg and Switzerland) for dengue, chikungunya, Zika, West Nile and Usutu viruses. Methods: A bibliographical search with research strings addressing mosquito vector competence for considered countries was performed. Results: Out of 6357 results, 119 references were related to the vector competence of mosquitoes in Western Europe. Eight species appear to be competent for at least one virus. Conclusions: Aedes albopictus is responsible for the current outbreaks. The spread of Aedes albopictus and Aedes japonicus increases the risk of the autochthonous transmission of these viruses. Although native species could contribute to their transmission, more studies are still needed to assess that risk.
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Affiliation(s)
- Jean-Philippe Martinet
- Faculté de Pharmacie, Université de Reims Champagne-Ardenne, ANSES, SFR Cap Santé, EA7510 ESCAPE–USC VECPAR, 51 rue Cognacq-Jay, 51096 Reims CEDEX, France; (H.F.); (J.D.)
- Arbovirus et Insectes Vecteurs, Département de Virologie, Institut Pasteur, 25-28 rue du docteur Roux, 75015 Paris, France;
- Correspondence:
| | - Hubert Ferté
- Faculté de Pharmacie, Université de Reims Champagne-Ardenne, ANSES, SFR Cap Santé, EA7510 ESCAPE–USC VECPAR, 51 rue Cognacq-Jay, 51096 Reims CEDEX, France; (H.F.); (J.D.)
- Laboratoire de Parasitologie, Hôpital Maison-Blanche, CHU de Reims, 45 rue Cognacq-Jay, 51100 Reims, France
| | - Anna-Bella Failloux
- Arbovirus et Insectes Vecteurs, Département de Virologie, Institut Pasteur, 25-28 rue du docteur Roux, 75015 Paris, France;
| | - Francis Schaffner
- National Centre for Vector Entomology, Institute of Parasitology, Vetsuisse Faculty, University of Zurich, Rämistrasse 71, 8006 Zürich, Switzerland;
- Francis Schaffner Consultancy, Lörracherstrasse 50, 4125 Riehen (Basel-Land), Switzerland
| | - Jérôme Depaquit
- Faculté de Pharmacie, Université de Reims Champagne-Ardenne, ANSES, SFR Cap Santé, EA7510 ESCAPE–USC VECPAR, 51 rue Cognacq-Jay, 51096 Reims CEDEX, France; (H.F.); (J.D.)
- Laboratoire de Parasitologie, Hôpital Maison-Blanche, CHU de Reims, 45 rue Cognacq-Jay, 51100 Reims, France
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Proesmans S, Katshongo F, Milambu J, Fungula B, Muhindo Mavoko H, Ahuka-Mundeke S, Inocêncio da Luz R, Van Esbroeck M, Ariën KK, Cnops L, De Smet B, Lutumba P, Van Geertruyden JP, Vanlerberghe V. Dengue and chikungunya among outpatients with acute undifferentiated fever in Kinshasa, Democratic Republic of Congo: A cross-sectional study. PLoS Negl Trop Dis 2019; 13:e0007047. [PMID: 31487279 PMCID: PMC6748445 DOI: 10.1371/journal.pntd.0007047] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 09/17/2019] [Accepted: 08/06/2019] [Indexed: 12/25/2022] Open
Abstract
Background Pathogens causing acute fever, with the exception of malaria, remain largely unidentified in sub-Saharan Africa, given the local unavailability of diagnostic tests and the broad differential diagnosis. Methodology We conducted a cross-sectional study including outpatient acute undifferentiated fever in both children and adults, between November 2015 and June 2016 in Kinshasa, Democratic Republic of Congo. Serological and molecular diagnostic tests for selected arboviral infections were performed on blood, including PCR, NS1-RDT, ELISA and IFA for acute, and ELISA and IFA for past infections. Results Investigation among 342 patients, aged 2 to 68 years (mean age of 21 years), with acute undifferentiated fever (having no clear focus of infection) revealed 19 (8.1%) acute dengue–caused by DENV-1 and/or DENV-2 –and 2 (0.9%) acute chikungunya infections. Furthermore, 30.2% and 26.4% of participants had been infected in the past with dengue and chikungunya, respectively. We found no evidence of acute Zika nor yellow fever virus infections. 45.3% of patients tested positive on malaria Rapid Diagnostic Test, 87.7% received antimalarial treatment and 64.3% received antibacterial treatment. Discussion Chikungunya outbreaks have been reported in the study area in the past, so the high seroprevalence is not surprising. However, scarce evidence exists on dengue transmission in Kinshasa and based on our data, circulation is more important than previously reported. Furthermore, our study shows that the prescription of antibiotics, both antibacterial and antimalarial drugs, is rampant. Studies like this one, elucidating the causes of acute fever, may lead to a more considerate and rigorous use of antibiotics. This will not only stem the ever-increasing problem of antimicrobial resistance, but will–ultimately and hopefully–improve the clinical care of outpatients in low-resource settings. Trial registration ClinicalTrials.gov NCT02656862. Malaria remains one of the most important causes of fever in sub-Saharan Africa. However, its share is declining, since the diagnosis and treatment of malaria have improved significantly over the years. Hence leading to an increase in the number of patients presenting with non-malarial fever. Often, obvious clinical signs and symptoms like cough or diarrhea are absent, probing the question: “What causes the fever?” Previous studies have shown that the burden of arboviral infections–like dengue and chikungunya–in sub-Saharan Africa is underestimated, which is why we screened for four common arboviral infections in patients presenting with ‘undifferentiated fever’ at an outpatient clinic in suburban Kinshasa, Democratic Republic of Congo. Among the patients tested, we found that one in ten presented with an acute arboviral infection and that almost one in three patients had been infected in the past. These findings suggest that clinicians should think about arboviral infections more often, thereby refraining from the prescription of antibiotics, a practice increasingly problematic given the global rise of antimicrobial resistance.
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Affiliation(s)
| | - Freddy Katshongo
- Institut Supérieur des Techniques Médicales, Kinshasa, Democratic Republic of Congo
| | - John Milambu
- Centre Hospitalier Lisungi, Kinshasa, Democratic Republic of Congo
| | - Blaise Fungula
- Centre Hospitalier Lisungi, Kinshasa, Democratic Republic of Congo
| | - Hypolite Muhindo Mavoko
- University of Antwerp, Antwerp, Belgium.,Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Steve Ahuka-Mundeke
- Université de Kinshasa, Kinshasa, Democratic Republic of Congo.,Institut National de Reserche Biomédicale, Kinshasa, Democratic Republic of Congo
| | | | | | - Kevin K Ariën
- University of Antwerp, Antwerp, Belgium.,Institute of Tropical Medicine, Antwerp, Belgium
| | | | | | - Pascal Lutumba
- Université de Kinshasa, Kinshasa, Democratic Republic of Congo.,Institut National de Reserche Biomédicale, Kinshasa, Democratic Republic of Congo
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Wollants E, Smolders D, Naesens R, Bruynseels P, Lagrou K, Matthijnssens J, Van Ranst M. Use of Next-Generation Sequencing for Diagnosis of West Nile Virus Infection in Patient Returning to Belgium from Hungary. Emerg Infect Dis 2019; 24:2380-2382. [PMID: 30457549 PMCID: PMC6256386 DOI: 10.3201/eid2412.180494] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
An elderly patient in Belgium who became critically ill after returning from Hungary was tested for pathogens using routine diagnostic tests. All results were negative. However, using next-generation sequencing on a cultured respiratory sample, laboratorians detected a complete West Nile virus genome, similar to strains isolated in southeastern Europe.
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Boga JA, Alvarez-Arguelles ME, Rojo-Alba S, Rodríguez M, de Oña M, Melón S. Simultaneous detection of Dengue virus, Chikungunya virus, Zika virus, Yellow fever virus and West Nile virus. J Virol Methods 2019; 268:53-55. [DOI: 10.1016/j.jviromet.2019.03.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 03/11/2019] [Accepted: 03/27/2019] [Indexed: 11/28/2022]
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Salama M, Amitai Z, Lustig Y, Mor Z, Weiberger M, Chowers M, Maayan S, Zimhony O, Ben-Ami R, Chazan B, Zaltzman-Bershadsky N, Cohen R, Tsyba E, Sheffer R, Anis E, Glazer Y, Pessah S, Mendelson E, Leshem E. Outbreak of West Nile Virus disease in Israel (2015): A retrospective analysis of notified cases. Travel Med Infect Dis 2018; 28:41-45. [PMID: 30016649 DOI: 10.1016/j.tmaid.2018.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 07/12/2018] [Accepted: 07/13/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND West Nile Virus (WNV) is mosquito-borne virus that is endemic in Israel. In 2015, national disease surveillance demonstrated a sharp increase in disease cases, with 149 cases diagnosed. METHODS Clinical data was extracted from the patients' medical files and laboratory analysis on blood, cerebrospinal fluid or urine was carried out. Data on climate was extracted from the Israel Meteorological Service. RESULTS Neuroinvasive disease was reported in 70% of cases and case-fatality rate was 16%. Simultaneously with the outbreak, an intense heat wave and an upsurge in summer temperatures occurred. CONCLUSIONS Clinical data shows substantial morbidity and mortality of WNV disease in Israel. Climatic measures are consistent with previous reports and point to the importance of temperature monitoring and rapid implementation of preventive environmental measures during the summer to reduce potential mosquito breeding sites. WNV disease should be suspected as a cause of fever or neurologic disease in travelers returning from endemic countries.
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Affiliation(s)
- Matanelle Salama
- Tel Aviv District Health Office, Ministry of Health, Tel Aviv, Israel.
| | - Ziva Amitai
- Tel Aviv District Health Office, Ministry of Health, Tel Aviv, Israel
| | - Yaniv Lustig
- Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Israel
| | - Zohar Mor
- Tel Aviv District Health Office, Ministry of Health, Tel Aviv, Israel
| | - Miriam Weiberger
- Infectious Disease Unit, Assaf Harofeh Medical Center, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Shlomo Maayan
- Division of Infectious Diseases, Barzilai Medical Center, Israel
| | - Oren Zimhony
- Infectious Diseases, Kaplan Medical Center, Israel
| | - Ronen Ben-Ami
- Infectious Diseases Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | | | - Regev Cohen
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Israel
| | - Evgenia Tsyba
- Division of Infectious Diseases, Barzilai Medical Center, Israel
| | - Rivka Sheffer
- Tel Aviv District Health Office, Ministry of Health, Tel Aviv, Israel
| | - Emilia Anis
- Division of Epidemiology, Ministry of Health, Jerusalem, Israel
| | - Yael Glazer
- Division of Epidemiology, Ministry of Health, Jerusalem, Israel
| | - Silvia Pessah
- Division of Epidemiology, Ministry of Health, Jerusalem, Israel
| | - Ella Mendelson
- Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Israel
| | - Eyal Leshem
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Internal Medicine C', The Chaim Sheba Medical Center, Tel Hashomer, Israel
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Huits R, De Kort J, Van Den Berg R, Chong L, Tsoumanis A, Eggermont K, Bartholomeeusen K, Ariën KK, Jacobs J, Van Esbroeck M, Bottieau E, Cnops L. Chikungunya virus infection in Aruba: Diagnosis, clinical features and predictors of post-chikungunya chronic polyarthralgia. PLoS One 2018; 13:e0196630. [PMID: 29709007 PMCID: PMC5927412 DOI: 10.1371/journal.pone.0196630] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 04/16/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Chikungunya virus (CHIKV) emerged in Aruba for the first time in 2014. We studied the clinical presentation of acute CHIKV infection and the contribution of serologic and molecular assays to its diagnosis. In a cohort of confirmed CHIKV cases, we analysed the frequency, duration and predictors of post-chikungunya chronic polyarthralgia (pCHIK-CPA), defined as joint pains lasting longer than 6 weeks or longer than 1 year. METHODOLOGY Patient sera obtained within 10 days of symptom onset were tested for CHIKV, using an indirect immunofluorescence test for the detection of CHIKV-specific Immunoglobulin M (IgM) and post-hoc, by reverse-transcription polymerase chain reaction (RT-PCR). CHIKV was isolated from selected samples and genotyped. For confirmed CHIKV cases, clinical data from chart review were complemented by a Telephone survey, conducted 18-24 months after diagnosis. When joint pain was reported, the duration, presence of inflammatory signs, type and number of joints affected, were recorded. Joint involvement was scored according to the 2010 'American College of Rheumatology/ European League Against Rheumatism' criteria for seronegative rheumatoid arthritis (ACR-score). Risk factors for pCHIK-CPA were identified by logistic regression. PRINCIPAL FINDINGS Acute CHIKV infection was diagnosed in 269 of 498 sera, by detection of IgM (n = 105), by RT-PCR (n = 59), or by both methods (n = 105). Asian genotype was confirmed in 7 samples. Clinical data were complete for 171 of 248 (69.0%) patients, aged 15 years or older (median 49.4 [35.0-59.6]). The female-to-male ratio was 2.2. The main acute symptoms were arthralgia (94%), fever (85%), myalgia (85%), headache (73%) and rash (63%). In patients with arthralgia (n = 160), pCHIK-CPA longer than 6 weeks was reported by 44% and longer than 1 year by 26% of cases. Inflammatory signs, stiffness, edema and redness were frequent (71%, 39% and 21%, respectively). Joints involved were knees (66%), ankles (50%), fingers (52%), feet (46%), shoulders (36%), elbows (34%), wrists (35%), hips (31%), toes (28.1%) and spine (28.1%). Independent predictors of pCHIK-CPA longer than 1 year were female gender (OR 5.9, 95%-CI [2.1-19.6]); high ACR-score (7.4, [2.7-23.3]), and detection of CHIKV-RNA in serum beyond 7 days of symptom onset (6.4, [1.4-34.1]. CONCLUSIONS We identified 269 CHIKV patients after the first outbreak of Asian genotype CHIKV in Aruba in 2014-2015. RT-PCR yielded 59 (28%) additional CHIKV diagnoses compared to IgM antibody detection alone. Arthralgia, fever and skin rash were the dominant acute phase symptoms. pCHIK-CPA longer than 1 year affected 26% of cases and was predicted by female gender, high ACR-score and CHIKV-RNA detection beyond 7 days of symptom onset.
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Affiliation(s)
- Ralph Huits
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Jaclyn De Kort
- Department of Internal Medicine, Horacio Oduber Hospital, Oranjestad, Aruba
| | | | - Luis Chong
- Landslaboratorium Aruba, Oranjestad, Aruba
| | - Achilleas Tsoumanis
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Kaat Eggermont
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Koen Bartholomeeusen
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Kevin K Ariën
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.,Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Jan Jacobs
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.,Department of Microbiology and Immunology, University of Leuven, Leuven, Belgium
| | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Lieselotte Cnops
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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13
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Popescu CP, Florescu SA, Cotar AI, Badescu D, Ceianu CS, Zaharia M, Tardei G, Codreanu D, Ceausu E, Ruta SM. Re-emergence of severe West Nile virus neuroinvasive disease in humans in Romania, 2012 to 2017-implications for travel medicine. Travel Med Infect Dis 2018; 22:30-35. [PMID: 29544774 DOI: 10.1016/j.tmaid.2018.03.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 02/25/2018] [Accepted: 03/11/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND In Romania, after a major outbreak in 1996, West Nile neuroinvasive disease (WNND) was reported only in a limited number of cases annually. During 2016-2017, a significant increase in the number of WNND cases was reported at the national level, associated with high mortality rates. METHODS A retrospective analysis of all cases confirmed with WNND, hospitalized during 2012-2017 in a single tertiary facility from Bucharest was performed in order to determine the annual prevalence and mortality rate and the risk factors associated with a severe outcome. RESULTS 47 cases were confirmed as WNND. The mortality rate was 25.5%, all death occurred during 2016-2017. Coma, confusion, obtundation, sleepiness and depressed deep tendon reflexes were symptoms predicting a severe outcome. In a univariate analysis age (p < 0.001), associated cancers (p = 0.012) and low levels of chloride in the CSF (p = 0.008) were risk factors for mortality. In a multinomial logistic analysis, age older than 75 years remained the only independent predictor of death in WNND. CONCLUSIONS The increase in both the number and the mortality rate of WNND cases suggest a changing pattern of WNV infection in Romania. Public health authorities and clinicians should be aware of the risk of severe WNV infection in travelers returning from Romania.
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Affiliation(s)
- Corneliu Petru Popescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania; ESCMID Study Group for Infectious Diseases of the Brain, Basel, Switzerland; ESCMID Study Group for Infections in Travellers and Migrants, Basel, Switzerland.
| | - Simin Aysel Florescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania
| | - Ani Ioana Cotar
- Laboratory for Vector-Borne Infections, Cantacuzino National Institute for Research, Bucharest, Romania
| | - Daniela Badescu
- Laboratory for Vector-Borne Infections, Cantacuzino National Institute for Research, Bucharest, Romania
| | - Cornelia Svetlana Ceianu
- Laboratory for Vector-Borne Infections, Cantacuzino National Institute for Research, Bucharest, Romania
| | - Mihaela Zaharia
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania; ESCMID Study Group for Infectious Diseases of the Brain, Basel, Switzerland; ESCMID Study Group for Infections in Travellers and Migrants, Basel, Switzerland
| | - Gratiela Tardei
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania
| | - Daniel Codreanu
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania
| | - Emanoil Ceausu
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania
| | - Simona Maria Ruta
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Stefan S Nicolau Institute of Virology, Bucharest, Romania
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14
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γδ T Cells Play a Protective Role in Chikungunya Virus-Induced Disease. J Virol 2015; 90:433-43. [PMID: 26491151 DOI: 10.1128/jvi.02159-15] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 10/12/2015] [Indexed: 11/20/2022] Open
Abstract
UNLABELLED Chikungunya virus (CHIKV) is an alphavirus responsible for causing epidemic outbreaks of polyarthralgia in humans. Because CHIKV is initially introduced via the skin, where γδ T cells are prevalent, we evaluated the response of these cells to CHIKV infection. CHIKV infection led to a significant increase in γδ T cells in the infected foot and draining lymph node that was associated with the production of proinflammatory cytokines and chemokines in C57BL/6J mice. γδ T cell(-/-) mice demonstrated exacerbated CHIKV disease characterized by less weight gain and greater foot swelling than occurred in wild-type mice, as well as a transient increase in monocytes and altered cytokine/chemokine expression in the foot. Histologically, γδ T cell(-/-) mice had increased inflammation-mediated oxidative damage in the ipsilateral foot and ankle joint compared to wild-type mice which was independent of differences in CHIKV replication. These results suggest that γδ T cells play a protective role in limiting the CHIKV-induced inflammatory response and subsequent tissue and joint damage. IMPORTANCE Recent epidemics, including the 2004 to 2007 outbreak and the spread of CHIKV to naive populations in the Caribbean and Central and South America with resultant cases imported into the United States, have highlighted the capacity of CHIKV to cause explosive epidemics where the virus can spread to millions of people and rapidly move into new areas. These studies identified γδ T cells as important to both recruitment of key inflammatory cell populations and dampening the tissue injury due to oxidative stress. Given the importance of these cells in the early response to CHIKV, this information may inform the development of CHIKV vaccines and therapeutics.
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15
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Twelve years of dengue surveillance in Belgian travellers and significant increases in the number of cases in 2010 and 2013. Clin Microbiol Infect 2015; 21:867-72. [DOI: 10.1016/j.cmi.2015.05.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 03/04/2015] [Accepted: 05/13/2015] [Indexed: 11/21/2022]
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16
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Long KM, Heise MT. Protective and Pathogenic Responses to Chikungunya Virus Infection. CURRENT TROPICAL MEDICINE REPORTS 2015; 2:13-21. [PMID: 26366337 DOI: 10.1007/s40475-015-0037-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Chikungunya virus (CHIKV) is an arbovirus responsible for causing epidemic outbreaks of human disease characterized by painful and often debilitating arthralgia. Recently CHIKV has moved into the Caribbean and the Americas resulting in massive outbreaks in naïve human populations. Given the importance of CHIKV as an emerging disease, a significant amount of effort has gone into interpreting the virus-host interactions that contribute to protection or virus-induced pathology following CHIKV infection, with the long term goal of using this information to develop new therapies or safe and effective anti-CHIKV vaccines. This work has made it clear that numerous distinct host responses are involved in the response to CHIKV infection, where some aspects of the host innate and adaptive immune response protect from or limit virus-induced disease, while other pathways actually exacerbate the virus-induced disease process. This review will discuss mechanisms that have been identified as playing a role in the host response to CHIKV infection and illustrate the importance of carefully evaluating these responses to determine whether they play a protective or pathologic role during CHIKV infection.
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Affiliation(s)
- Kristin M Long
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, CB 7292, Chapel Hill, NC 27599
| | - Mark T Heise
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, CB 7292, Chapel Hill, NC 27599 ; Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC, CB 7292, Chapel Hill, NC 27599
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